﻿<%@ Page Language="C#" AutoEventWireup="true" CodeFile="AddQuanLyBenhNhan.aspx.cs" Inherits="AddQuanLyBenhNhan" %>

<%@ Register assembly="AjaxControlToolkit" namespace="AjaxControlToolkit" tagprefix="asp" %>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">

<html xmlns="http://www.w3.org/1999/xhtml">
<head runat="server">
    <title></title>
    <style type="text/css">

        .style1
        {
            width: 100%;
        }
        .style2
        {
            width: 133px;
        }
        .style3
        {
            width: 275px;
        }
        .style4
        {
            width: 275px;
            text-align: left;
        }
        </style>
</head>
<body>
    <form id="form1" runat="server">
    <div>
    
    <div class="main">
        <table class="style1">
            <tr>
                <td class="style2">
                    <asp:Label ID="Label2" runat="server" Text="Mã bệnh nhân"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtMaBenhNhan" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    <asp:Label ID="labValidation" runat="server"></asp:Label>
                </td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label3" runat="server" Text="Tên bệnh nhân"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtTenBenhNhan" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label4" runat="server" Text="Ngày sinh"></asp:Label>
                </td>
                <td class="style3">
                    
                    

                    <asp:TextBox ID="txtNgaySinh" runat="server" />
                       <asp:CalendarExtender ID="cDateOfBill"  runat="server" TargetControlID="txtNgaySinh" Format="dd/MM/yyyy" 
                        OnClientShown="calendarShown" PopupButtonID="Image1">                                                                                                        
                       </asp:CalendarExtender>
                    <asp:Image ID="Image1" runat="server" ImageUrl="images/calendar.png" />
                    
                    

                    </td>

                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label5" runat="server" Text="Giới tính"></asp:Label>
                </td>
                <td class="style3">
                    <asp:RadioButton ID="rdbNam" runat="server" Checked="True" Text="Nam" />
                    <asp:RadioButton ID="rdbNu" runat="server" Text="Nữ" />
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label6" runat="server" Text="Điện thoại"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtDienThoai" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label7" runat="server" Text="Địa chỉ"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtDiachi" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label8" runat="server" Text="Nơi làm việc"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtNoiLamViec" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label9" runat="server" Text="Đối tượng"></asp:Label>
                </td>
                <td class="style3">
                    <asp:DropDownList ID="drpDoiTuong" runat="server" Height="20px" Width="144px">
                    </asp:DropDownList>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label10" runat="server" Text="Mã bảo hiểm y tế"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtMaBaoHiem" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label11" runat="server" Text="Ngày BD BHYT"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtNgayBD_BHYT" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label12" runat="server" Text="Ngày KT BHYT"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtKT_BHYT" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label13" runat="server" Text="Tên cha"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtTenCha" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label14" runat="server" Text="Tên mẹ"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtTenMe" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label15" runat="server" Text="Người liên hệ"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtNGuoiLienHe" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    <asp:Label ID="Label16" runat="server" Text="Địa chỉ liên hệ"></asp:Label>
                </td>
                <td class="style3">
                    <asp:TextBox ID="txtDiaChiLienHe" runat="server" Width="217px"></asp:TextBox>
                </td>
                <td>
                    &nbsp;</td>
            </tr>
            <tr>
                <td class="style2">
                    &nbsp;</td>
                <td class="style4">
                    <asp:Button ID="bntThem" runat="server" Text="Thêm" />
&nbsp;&nbsp;
                    <asp:Button ID="btnThoat" runat="server" Text="Thoát" />
                </td>
                <td>
                    &nbsp;</td>
            </tr>
        </table>
    </div>
    
    </div>
    <asp:ScriptManager ID="ScriptManager1" runat="server">
    </asp:ScriptManager>
    </form>
</body>
</html>
